Robotic-assisted total knee arthroplasty may lead to improvement in quality-of-life measures: a 2-year follow-up of a prospective randomized trial

Liow, Ming Han Lincoln; Goh, Graham S.; Wong, Manzhi; Chin, Pak Lin; Tay, Darren Keng Jin; Yeo, Seng-Jin

doi:10.1007/s00167-016-4076-3

Cited by 151 publications

(132 citation statements)

References 35 publications

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“…Six-month manual versus robotic TKA WOMAC scores are still potentially relevant. Liow et al26 performed a randomized controlled trial of 60 knees (31 robotic assisted and 29 manual), and found the robotic-assisted cohort to have higher Short Form (SF)-36 quality of life measures. Specifically, the group noted a significant difference in SF-36 vitality (p ¼ 0.03), emotional role (p ¼ 0.02), and a larger number of patients reaching SF-36 vitality minimum clinically important difference (48 vs. 14%, p ¼ 0.009), all in favor of the robotic group.…”

mentioning

confidence: 99%

Patient Satisfaction Outcomes after Robotic Arm-Assisted Total Knee Arthroplasty: A Short-Term Evaluation

Marchand¹,

et al. 2017

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Robotic arm-assisted total knee arthroplasty (RATKA) presents a potential, new added value for orthopedic surgeons. In today's health care system, a major determinant of value can be assessed by patient satisfaction scores. Therefore, the purpose of the study was to analyze patient satisfaction outcomes between RATKA and manual total knee arthroplasty (TKA). Specifically, we used the Western Ontario and McMaster Universities Arthritis Index (WOMAC) to compare (1) pain scores, (2) physical function scores, and (3) total patient satisfaction outcomes in manual and RATKA patients at 6 months postoperatively. In this study, 28 cemented RATKAs performed by a single orthopedic surgeon at a high-volume institution were analyzed. The first 7 days were considered as an adjustment period along the learning curve. Twenty consecutive cemented RATKAs were matched and compared with 20 consecutive cemented manual TKAs performed immediately. Patients were administered a WOMAC satisfaction survey at 6 months postoperatively. Satisfaction scores between the two cohorts were compared and the data were analyzed using Student's t-tests. A p-value < 0.05 was used to determine statistical significance. The mean pain score, standard deviation (SD), and range for the manual and robotic cohorts were 5 ± 3 (range: 0–10) and 3 ± 3 (range: 0–8, p < 0.05), respectively. The mean physical function score, SD, and range for the manual and robotic cohorts were 9 ± 5 (range: 0–17) and 4 ± 5 (range, 0–14, p = 0.055), respectively. The mean total patient satisfaction score, SD, and range for the manual and robotic cohorts were 14 points (range: 0–27 points, SD: ± 8) and 7 ± 8 points (range: 0–22 points, p < 0.05), respectively. The results from this study further highlight the potential of this new surgical tool to improve short-term pain, physical function, and total satisfaction scores. Therefore, it appears that patients who undergo RATKA can expect better short-term outcomes when compared with patients who undergo manual TKA.

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confidence: 99%

Patient Satisfaction Outcomes after Robotic Arm-Assisted Total Knee Arthroplasty: A Short-Term Evaluation

Marchand¹,

et al. 2017

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“…15 Furthermore, the CT scan-based patient-specific three-dimensional joint rendering has been shown to enhance preoperative planning. 16 These reasons, as well as potentially many others, are likely to contribute to the 1-year outcome results in RAA patients.…”

Section: Discussionmentioning

confidence: 99%

One-Year Patient Outcomes for Robotic-Arm-Assisted versus Manual Total Knee Arthroplasty

Marchand¹,

Sodhi

Anis

et al. 2019

J Knee Surg

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Although there are many studies on the alignment advantages when using the robotic arm–assisted (RAA) system for total knee arthroplasty (TKA), there have been questions regarding patient-reported outcomes. Therefore, the purpose of this study was to use this index to compare: (1) total, (2) physical function, and (3) pain scores for manual versus RAA patients. We compared 53 consecutive RAA to 53 consecutive manual TKAs. No differences in preoperative scores were found between the cohorts. Patients were administered a modified Western Ontario and McMaster Universities Osteoarthritis Index satisfaction survey preoperatively and at 1-year postoperatively. The results were broken down to: (1) total, (2) physical function, and (3) pain scores. Univariate analysis with independent samples t-tests was used to compare 1-year postoperative scores. Multivariate models with stepwise backward linear regression were utilized to evaluate the associations between scores and surgical technique, age, sex, as well as body mass index (BMI). Statistical analyses were performed with a p < 0.05 to determine significance. The RAA cohort had significantly improved mean total (6 ± 6 vs. 9 ± 8 points, p = 0.03) and physical function scores (4 ± 4 vs. 6 ± 5 points, p = 0.02) when compared with the manual cohort. The mean pain score for the RAA cohort (2 ± 3 points [range, 0–14 points]) was also lower than that for the manual cohort (3 ± 4 points [range, 0–11 points]) (p = 0.06). On backward linear regression analyses, RAA was found to be significantly associated with more improved total (β coefficient [β] −0.208, standard error [SE] 1.401, p < 0.05), function (β = 0.216, SE = 0.829, p < 0.05), and pain scores (β −0.181, SE = 0.623, p = 0.063). The RAA technique was found to have the strongest association with improved scores when compared with age, gender, and BMI. This study suggests that RAA patients may have short-term improvements at minimum 1-year postoperatively. However, longer term follow-up with greater sample sizes is needed to further validate these results.

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“…27,28 Several controlled 9,11,12,29 and noncontrolled 30,31 trials have demonstrated that the use of this robotic system increases the accuracy in restoration of mechanical axis within AE 3 degrees (from neutral alignment) during TKA, 27 without significantly increasing surgical time compared with conventional procedures. 9,11,29 Furthermore, Liow et al 11 showed that patients undergoing robotic-assisted TKA might score better in SF-36 vitality and emotional components at 2 years postoperatively. However, other studies have not seen this difference, 12,29 and a significant improvement in range of motion, function, and quality of life in the mid and long terms with the use of Robodoc has yet to be determined.…”

Section: Robodocmentioning

confidence: 99%

“…Liow et al found one periprosthetic joint infection requiring revision surgery in 31 patients who underwent robotic-assisted TKA and 2 patients with deep vein thrombosis. 11 Siebert et al 49 described wound complications in 3 of 70 patients. Park and Lee 50 in a randomized study of 32 patients allocated to robotic-assisted TKA reported one surgical site infection, one patellar tendon rupture, two periprosthetic fractures, and one neurovascular injury.…”

Section: Surrogate Outcomesmentioning

confidence: 99%

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Robotics in Total Knee Arthroplasty

2019

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Total knee arthroplasty (TKA) is a highly successful operation that improves patients' quality of life and functionality. Yet, up to 20% of TKA patients remain unsatisfied with their clinical result. Robotic TKA has gained increased attention and popularity as a means of improving patient satisfaction. The promise of robotic-assisted TKA is that it provides a surgeon with a tool that accurately executes bone cuts according to presurgical planning, as well as provides the surgeon with intraoperative feedback helpful for restoring knee kinematics and soft tissue balance. Several systems are now available, each with their own advantages and disadvantages. Evidence that the use of robotics will lead to improved implant survival, function, and patient-reported outcomes is slowly being accumulated, but this has not been clearly proven to date. Recent literature does show that the use of robotics during TKA is not associated with increased surgical time or complications. The goal of this review is to provide an objective assessment of the evidence surrounding robotic technology for TKA.

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Robotic-assisted total knee arthroplasty may lead to improvement in quality-of-life measures: a 2-year follow-up of a prospective randomized trial

Abstract: II.

Cited by 151 publications

References 35 publications

Patient Satisfaction Outcomes after Robotic Arm-Assisted Total Knee Arthroplasty: A Short-Term Evaluation

Patient Satisfaction Outcomes after Robotic Arm-Assisted Total Knee Arthroplasty: A Short-Term Evaluation

One-Year Patient Outcomes for Robotic-Arm-Assisted versus Manual Total Knee Arthroplasty

Robotics in Total Knee Arthroplasty

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